CTDS News

We would like to welcome Doug Hayward to CTDS. Doug joined us in February as our resident in clinical pathology and is already settling in well. Doug was born and raised in Johannesburg, South Africa. After completing his schooling, he attended the University of Pietermaritzburg until 1995 when he graduated with a Bachelor of Science degree in Zoology and Grassland Science. He then attended the University of Pretoria, Onderstepoort, South Africa and graduated as a Bachelor of Veterinary Science in 2000. After six months in South Africa working in a mixed avian/small animal practice, he emigrated to the United Kingdom in 2001. After spending one and a half years in small animal practice in Luton, he took six months off from veterinary practice to travel, followed by two and a half years in small animal practice in Epsom. He joined CTDS in February 2006 as Resident in Clinical Pathology to pursue his interest in veterinary laboratory diagnostics and cytology.

Nick Carmichael was recently recognised by the RCVS as a specialist in clinical pathology. RCVS recognised specialist status is not easily achieved and we believe adds value to our services that is difficult to match. To be included on the exclusive list of Recognised Specialists, an individual must have achieved a postgraduate qualification at least at Diploma level, and must additionally satisfy the RCVS that they make an active contribution to their specialty, have national and international acclaim and publish in their field. We would like to congratulate Nick on this achievement.

New tests

We are pleased to be able to offer improved turnaround for calculus (stone) analysis.
Calculus, stone, uroliths analysis.

Reports are now available 24-48 hours after receipt.
Test code: M6 (no change)
Price: £17.00 + VAT (no change)

Ionised calcium tests are now available through CTDS.
Test code: CAI
Price : £15.00 + VAT
Sample requirements: Plain serum (not gel) or whole blood taken into a plain tube.

Ionised calcium

Ionised calcium is sometimes indicated in the investigation of hypocalcaemia and hypercalcaemia, often before PTH measurement.
Ionised calcium is the component of total calcium which is not bound to serum proteins or chelated with anions such as citrate. Essentially it is the metabolically active component which is available to cells involved in neuromuscular transmission and most accurately reflects calcium status.
If total calcium is reduced on a profile this can reflect a true reduction in ionised calcium or a reduction in bound calcium while the metabolically active component remains unaffected. In dogs there are formulae to correct total calcium for hypoalbuminaemia and we use one of these to generate ” corrected calcium” results on reports where albumin is reduced.
However, in other species formulae are not generally available and even in dogs a direct measurement is preferable. Increased total calcium can reflect a true increase in ionised calcium, dehydration or increased chelated calcium. The latter can occur in chronic renal failure and only measurement of ionised calcium can reliably differentiate these possibilities.
Given the diagnostic significance of genuinely increased calcium concentrations with regard to the presence of hypercalcaemia of malignancy and parathyroid gland neoplasia the direct measurement of ionised calcium is a valuable additional test before undertaking extensive further investigation.

Case of the month

We have recently had a series of cats with an unusual manifestation of autoimmunity, immune mediated neutropenia.
This condition has many similarities to, and can occur alongside, immune mediated haemolytic anaemia and thrombocytopenia. The pathogenesis is thought to be similar with abnormal autoantibodies binding to neutrophils which then become consumed by macrophages.
The haematological results are a very severe neutropenia which is persistent and is not accompanied by abnormal neutrophil morphology. In one case the neutrophil count initially was 0.05 x109 /l whilst in another there were no detectable neutrophils at all!
The clinical consequences relate to opportunistic bacterial infection as a result of the lack of neutrophils and all the cases had antibiotic responsive pyrexia and sometimes increased bilirubin as a result of a probable ascending bacterial cholangitis.
The diagnostic approach is to exclude other causes of severe neutropenia including drug or retrovirus associated myelosupression, primary bone marrow failure and causes of transient reductions in neutrophils such as acute inflammation, endotoxaemia or acute viral infection. Next step is a bone marrow to check for production of neutrophils despite their low numbers in peripheral blood. Unfortunately there is no comparable test to the Coombs test to check for anti-neutrophil antibodies directly.
The outlook for the cases we have seen has generally been good following immunosuppressive therapy and antibiotic cover with a relatively swift recovery in the neutrophil counts. We have two longer standing cases which have been successfully controlled for more than a year following diagnosis both of which appear well. If there is also immune mediated haemolytic anaemia or thrombocytopenia however the outlook may be more guarded.

Rabies serology+ health check offer

Until the end of July 2006 we are pleased to be able to offer a discounted feline or canine screen with Rabies serology tests.
Why not take the opportunity whilst the client is in the surgery for Rabies testing to incorporate a biochemical and haematology health check at the same time.
Rabies serology: normal price £35.00 +VAT
Feline or canine screen: normal price £17.00 + VAT
Rabies + screen – discounted price £45.00 + VAT

Simply submit 2 serum gel tubes, 1 EDTA and 1 Glucose tube and a rabies and standard request form at the same time.

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